Abstract
In December of 1987, the Wisconsin supreme court held that all involuntarily committed mental patients in the state had the right to refuse psychotropic medication unless a court held that they were incompetent to make treatment decisions. The authors studied the effects of this decision in a 165-bed forensic hospital over the first six months after implementation of the decision. They found that 29 percent of patients already on psychotropic medication initially refused further treatment as opposed to 75 percent of newly admitted patients. Of refusers, 32 percent eventually resumed taking medication voluntarily; courts overturned the refusals of all the 51 percent who maintained their refusals, after an average delay of over a month. The length of procedural delays actually increased over the six months of the study as the courts learned of the decision. The authors compare their findings with other reported studies of implementation of right to refuse treatment decisions and discuss differences between the right to refuse treatment for civilly and criminally committed patients.
Footnotes
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Dr. Miller is training director, Forensic Center, Mendota Mental Health Institute, Madison, WI, clinical associate professor of psychiatry and Lecturer in law, University of Wisconsin-Madison, and associate clinical professor of psychiatry, Medical College of Wisconsin, Milwaukee. Dr. Bernstein is unit chief, Forensic Rehabilitation Services II Unit, Forensic Center, Mendota Mental Health Institute. Dr. Van Rybroek is unit chief, Management Unit, Forensic Center, Mendota Mental Health Institute. Dr. Maier is clinical director, Forensic Center, Mendota Mental Health Institute. Address reprint requests to Dr. Miller, Forensic Center, Mendota Mental Health Institute, 301 Troy Drive, Madison, WI 53704.
- Copyright © 1989, The American Academy of Psychiatry and the Law
